Rise and Shine

By staff March 1, 2008

Modern society is wired in more ways than one. In the 24/7 world of the 21st century, the average adult gets an hour and a half less sleep than someone who lived 100 years ago. When people do sleep, they don’t sleep as well. The National Sleep Foundation estimates that 70 million Americans suffer from some kind of sleep disorder. That’s an estimate because only 15 percent of sleep sufferers have been diagnosed by a physician.

Dr. Matthew Edlund is a psychiatrist, a sleep medicine expert and the director of Sarasota’s Center for Circadian Medicine. He’s also the author of The Body Clock Advantage and several other books on health and wellbeing. Sleep is his specialty.

As Edlund sees it, the quality of sleep time can’t be separated from the quality of your waking life. That’s why he thinks the term “sleep disorder” can be misleading. “It’s more of a lifestyle disorder,” he says. “The quality of sleep reflects the entire state of the human organism. We’re not machines. We don’t have on-off switches.”

In Edlund’s view, good sleep is the result of good food, activity and rest—the three basic requirements of the human organism. His simple mnemonic for these three needs is “F.A.R.”

“Our body works as a unified system—its components work together, not separately,” he says. “The right foods, activity and rest allow the body to work at peak efficiency at all times, including sleep. Once you recognize this principle, you can literally go far.”

Let’s break it down:


Breakfast really is the most important meal of the day, the time to fuel the body for the day; lunch and dinner should be much lighter. “It doesn’t make sense to dump a load of calories and complex carbohydrates on the body just prior to eight hours of inactivity,” Edlund says. “Eating huge dinners is a fairly modern idea, and not a good one.”


Exercise helps you sleep—if you do it earlier in the day. Just don’t do it an hour before you turn off the lights. Edlund stresses that exercising goes beyond an hour or so in the gym; it should be part of a total active lifestyle. “There’s a basic polarity,” says Edlund. “The more vigorous you are during your waking hours, the better your quality of sleep.”

The opposite is also true. People who are barely awake during the day are barely asleep at night.

“It’s a simple principle,” Edlund says. “When you’re awake, be really awake. When you’re asleep, really sleep. Don’t mix the two.”


The nightly state of rest is part of the body’s circadian rhythms, a biological clock of metabolic changes running on a 25-hour period. Circadian rhythms influence body temperature, hormone levels and a host of other biological functions. Getting in synch with your inner cycles can improve your health, performance, and relationships, says Edlund. He instructs his patients to use strategically timed true-spectrum light therapy, exercise, short naps, and hot baths before sleep to keep body clocks on time.

“It helps to establish a bedtime routine,” Edlund says. You may be too old for Goodnight Moon, but a little Tolstoy before bed never hurts. And, if the day’s anxieties prey on your mind, try listening to a comedy album on your iPod or CD player.

For the body to rest, the mind must rest. Edlund feels that this can usually be done without medication.

“F.A.R. is a whole-systems approach,” he says. “In most cases, people with sleeping problems can correct those problems by changing a few simple habits.” It’s not a quick fix, like the purple Lunesta butterfly that flies in your window in the commercials, he cautions. “What we really need takes dedication—but the results give you more than a good night’s sleep. It’s a healthier way to live.”

Edlund feels that, in most cases, a good night’s sleep is the result of simple common sense. “Most of the things your parents told you as a child happen to be true,” he says. Edlund prescribes four simple steps for achieving healthy sleep habits:

· Go to bed at the same time every night

· Wake up at the same time every morning


· Have calm time before sleep

· Stay physically active during the day

Sleep experts like Edlund agree on plenty of “don’ts.”

“Don’t watch TV right before bed—and if you do, don’t watch the news or a horror movie,” he says.

Other “don’ts” include jolting the brain with caffeine and alcohol, interrupting the natural sleep cycle, keeping the finger on the worry button—and eyeing the clock every 15 minutes. If these “don’ts” sound fairly obvious, that’s because they are. “Common sense will tell you what to avoid,” says Edlund. “It’s surprising how uncommon it is for many people.”

Edlund cautions that as we age, we may perceive such unwelcome changes in our sleep patterns as fragmented sleep (more rapid sleep cycles), a decrease in deep sleep, and more awakening between sleep cycles. Not only the quantity but the quality of sleep suffers as we age. In addition, certain hormones decrease as we get older and may alter former sleep/wake timeframes so that we feel like going to bed earlier and waking up earlier.

Other common causes of sleep problems include pain or medical illness, complications from medications, depression and anxiety, and a variety of sleep disorders, including restless legs syndrome (RLS), insomnia, and sleep-disordered breathing such as snoring and sleep apnea.

But is lack of sleep really a problem? Aren’t all these wide-awake people enjoying more hours of consciousness, getting more work done, and experiencing life more fully? You might think that. But you’d be wrong.

People need sleep. It’s not an indulgence. It’s a survival need, like food, air and water. Animal research proves it. Rats live an average of five weeks—in comparison to their normal two or three years—when deprived of REM sleep, and an average of only three weeks when deprived of all sleep. Insomniac rats also suffer from low body temperatures and sores, both signs of an impaired immune system. Humans caught up in the sleepless rat race suffer a similar fate. The bottom line? Chronic sleeplessness can lead to the big sleep. The good news: A good night’s sleep is good for you.

If the human body came with an owner’s manual, it would tell you that the brain needs sleep. Sleep itself is not a simple reduction of mental activity. Sleep breaks down into five stages; in each one of them, the brain is highly active—in fact, certain nerve cells fire five to 10 times more frequently in some sleep states.

Sleep progresses through the first four stages, then culminates in the fifth stage: REM (rapid eye movement) sleep, in which people experience the most vivid dreaming. Following REM sleep, the cycle resumes. Adults spend about half their sleep in the REM state; infants spend more. Scientists theorize that the brain knits memories together in sleep—which may explain why babies and children need more down time.

The body also repairs and rebuilds itself during sleep. Cells produce more proteins—the building blocks of tissue growth. Like a busy factory, the body repairs the daily damages of stress and ultraviolet radiation during the night shift. You may be fast asleep, but your body is hard at work.

The benefits of good sleep? As Edlund puts it, you can help delay or avoid the diseases of civilization, which kill thousands of people every day. You can use your body’s capacity to renew and rebuild to change the way you look, the way you feel, and your ability to think. You can learn new ways to make the ordinary activities of life produce extraordinary results. You can feel better. Live longer. And feel more creative.

“All it takes is a little understanding about human design,” he says. “Sleep is not wasted time. Once we understand that fully, we’re on our way to becoming healthier human beings.”


There are more than 100 types of sleep disorders; here are five of the most common:

Insomnia: Difficulty falling asleep, waking and inability to return to sleep, waking too early or un-refreshing sleep.

Obstructive sleep apnea: Brief cessations in breathing during sleep, caused by a physical obstruction, with loud snoring, excessive daytime sleepiness and morning headaches.

Central sleep apnea: Brief cessations in breathing during sleep, caused by a central nervous system or cardiac dysfunction, with excessive daytime sleepiness, snoring and awakening with shortness of breath.

Narcolepsy: Excessive sleepiness with the uncontrollable urge to fall asleep, sudden muscle loss, sleep paralysis and hypnagogic hallucinations.

Restless Legs Syndrome (RLS): Creeping, crawling, tingling or aching sensation in the leg(s) that occur just before falling asleep and create an irresistible urge to move leg(s).

Fast Facts

20 to 40 percent of all adults have insomnia in the course of any year

Over 70 million Americans suffer from disorders of sleep and wakefulness

Over 18 million Americans suffer from sleep apnea

Over 50 percent of all apnea cases are diagnosed in people aged 40 and over


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